Safety and Gut Microbiota Analysis of an Oral Microbiotherapy in Patients With Amyotrophic Lateral Sclerosis

NCT ID: NCT05889572

Last Updated: 2025-06-15

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: PHASE1
• Total Enrollment: 15 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-06-08
• Study Completion Date: 2024-07-22

Brief Summary

The purpose of this pilot study is to assess the safety and tolerability of multiple doses of MaaT033 in ALS patients and to analyze the gut microbiota composition and evolution before considering a larger randomized controlled efficacy study.

Detailed Description

This is a prospective, single arm, open-label study.

The target population includes subjects with a recent disease onset defined as the time from first motor deficit at screening of at least 6 months and up to 24 months and removing very rapid/slow progressors based on the ALS Functional Rating Scale - Revised (ALSFRS-R) progression slope.

After a screening period (clinical examination, blood sampling), subject will come for a baseline visit (clinical examination, blood and feces sampling) and to initiate a bowel preparation phase. Five days later, subject will come back to the study site (clinical examination, blood sampling) to initiate a first Maat033 treatment period of 28-day. Ten days after MaaT033 treatment initiation a remote visit is included (feces sampling) to check the subject safety/tolerability. After the first Maat033 treatment period, subject will come to the study site (clinical examination, blood and feces sampling) to initiate the second MaaT033 treatment period of 28-day. At the end of the second Maat033 treatment period subjects will come to the study site (clinical examination, blood and feces sampling) and start a 28-day follow-up period without treatment.

Study completion is defined when all subjects enrolled completed the study follow-up period (clinical examination, blood and feces sampling) or earlier if a subject discontinued the study.

Conditions

Amyotrophic Lateral Sclerosis; ALS

Study Design

• Allocation Method: NA
• Intervention Model: SINGLE_GROUP
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

MaaT033

Route of administration: oral (capsule)

Between D-5 to D-1: Bowel preparation with Macrogol and Rifamixin

Between D1 to D28: MaaT033 treatment period 1

Between D28 to D56: MaaT033 treatment period 2

Group Type: EXPERIMENTAL

MaaT033

Intervention Type: DRUG

MaaT033 is a Microbiome Ecosystem Therapy (MET), composed of allogeneic, full-ecosystem pooled biotherapeutic gut microbiota.

Interventions

MaaT033

MaaT033 is a Microbiome Ecosystem Therapy (MET), composed of allogeneic, full-ecosystem pooled biotherapeutic gut microbiota.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Male or female subjects aged between18 and 80 years
• ALS meeting the revised El Escorial criteria for possible, probable, laboratory-supported probable, or definite ALS (familial or sporadic)
• Time since first motor deficit at screening: at least 6 months, up to 24 months
• Slope of progression of ALS Functional Rating Scale - revised (ALSFRS-R) from date of symptom onset to date of screening test (ΔFS/number of months) between [0.4 and 1.1]
• Able to swallow study treatments (including capsules without opening or chewing them) as per the investigator's assessment
• SVC (Slow Vital Capacity) equal to or greater than 70% of the predicted normal value for sex, height, and age at the screening visit
• If taking riluzole, subject must be on a stable dose for ≥30 days
• Signature of written informed consent by subject

Exclusion Criteria

• Subjects with a non-invasive ventilation, a tracheotomy and /or a gastrostomy
• Known autoimmune diseases, inflammatory disorders (SLE, Rheumatoid arthritis, connective tissue disorder) or chronic infections (HIV, hepatitis B, or C infection, Tuberculosis)
• Known hypersensitivity to rifaximin or macrogol or any of its components
• Known allergy or intolerance to trehalose, maltodextrin or Polyethylene Glycol (PEG)
• Documented hepatic impairment (Alanine Transaminase/ Aspartate Transaminase > 5N)
• Subject with white blood cells < 4000/ mm3; Polynuclear neutrophils < 1.5 G/ L
• Active infection requiring systemic antimicrobial therapy within 2-week prior to screening visit
• Active infection requiring systemic antimicrobial therapy between screening and baseline
• Medical condition requiring proton pump inhibitors (PPIs)
• Gastrointestinal obstruction or perforation
• Any gastro-intestinal bleeding in the past 3 months
• Gastric emptying disorders (gastroparesis)
• Toxic megacolon
• Severe forms of inflammation of the intestinal tract, including Crohn's disease and ulcerative colitis
• Severe vital organ dysfunctions unrelated to ALS and not compatible with experimental treatment, as per the investigator's assessment
• Subjects with negative IgG serology for Epstein Barr virus (EBV)
• Women of childbearing potential1 without effective contraceptive protection
• Nursing or pregnant women
• Any condition that, in the opinion of the investigator, may interfere with full participation in the study, including administration of study drug (and its preparation procedure) and attendance at required study visits; represent a significant risk to the subject; or interfere with the interpretation of study data
• Enrollment in another trial or expanded access program that may interfere with this study
• Guardianship/legal protection/curatorship of subjects
• Vulnerable subjects such as: persons deprived of liberty, persons in intensive care units unable to provide informed consent prior to the procedure

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

MaaT Pharma

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Gaelle Bruneteau, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Hôpital de la Pitié-Salpêtrière - CIC Neuroscience

Locations

Centre Hospitalier Universitaire de Lille - CIC

Lille, , France

Hôpital de la Pitié-Salpêtrière - CIC Neuroscience

Paris, , France

Countries

France

Other Identifiers

MPNS01

Identifier Type: -

Identifier Source: org_study_id